Multidisciplinary management of metastatic renal cell carcinoma in the era of targeted therapies

Escudier, Bernard; Osanto, Susanne; Ljungberg, Börje; Porta, Camillo; Wagstaff, John; Mulders, Peter F.A.; Gore, Martin; Bex, Axel; Bellmunt, Joaquim; Bracarda, Sergio; Franklin, Alex; Honoré, Per Hartvig; Ravaud, Alain; Steijn, Jeanne van; Aziz, Zeba; Akaza, Hideyuki

doi:10.1016/j.ctrv.2011.05.006

Cited by 10 publications

(3 citation statements)

References 30 publications

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“…[11, 15] Around 70% of our participants noted that their practice does routinely consult with non-oncology specialists for management of targeted therapy-related AEs [Q7], which is in contrast to 31% in a previous item [Q3]. This discrepancy may be attributed to the difference in wording between the two questions (specific versus unfamiliar AEs) and the multiple-selection format of Q3; respondents may have implicitly ranked their most frequent management measure rather than selecting all that were applicable, leading to an underestimation of the true prevalence of outside referral.…”

Section: Discussionmentioning

confidence: 99%

Current Practices in the Management of Adverse Events Associated With Targeted Therapies for Advanced Renal Cell Carcinoma: A National Survey of Oncologists

Ruiz

Belum

Creel

et al. 2014

Clinical Genitourinary Cancer

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Introduction Oncologists treating patients with targeted therapies encounter adverse events (AEs) that pose management challenges, lead to dosing inconsistencies, and impact patient quality of life. Oncologists' practices and attitudes in the management of targeted therapy-related AEs in renal cell carcinoma (RCC) patients are poorly understood. We sought to identify unmet needs associated with AE management and understand oncologists' treatment optimization strategies. Methods A 24-item online survey was administered in August 2012 to 119 U.S. oncologists treating advanced RCC patients. The survey solicited responses regarding demographics, practice settings, AE management practice patterns and beliefs, treatment barriers, and patient education. Results Respondents indicated between 25-50% of patients require dose modification/discontinuation due to AEs. The greatest barrier to optimizing treatment for RCC is the unpredictability of patient responses to treatment (43%). Most respondents (78%) discuss AE management with patients, but only a minority proactively reaches out to patients (46%). Most practitioners (70%) refer patients to non-oncology specialists when faced with unfamiliar AEs, although finding interested physicians (43%) and time constraints (40%) were the most commonly cited barriers to consulting with other specialties. Conclusion Results suggest that many patients require dose modifications/discontinuation due to AEs, and that non-oncologists are a frequently utilized resource to manage these events. There is a need for predictive drug toxicity markers to establish counseling and prevention, along with opportunities for increased education on supportive care techniques to maintain quality of life and consistent dosing.

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Section: Discussionmentioning

confidence: 99%

Current Practices in the Management of Adverse Events Associated With Targeted Therapies for Advanced Renal Cell Carcinoma: A National Survey of Oncologists

Ruiz

Belum

Creel

et al. 2014

Clinical Genitourinary Cancer

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“…Pharmacists may contribute towards the effective management of cancer-related pain, nausea and emesis. In relation to targeted agents, they have a potential role in informing patients about the prevention of toxicities and in advising on their management 42 .…”

Section: Discussionmentioning

confidence: 99%

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2012

IJPSR

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“…However, the most frequently occurring affect the skin, colon, endocrine organs, liver, and lungs. Others are very infrequent but may be very serious, even lethal, such as neurological disorders and myocarditis ( 12 ).…”

Section: Introductionmentioning

confidence: 99%

The value of the multidisciplinary team in metastatic renal cell carcinoma: Paving the way for precision medicine in toxicities management

et al. 2023

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The new landscape of treatments for metastatic clear cell renal carcinoma (mRCC) is constantly expanding, but it is associated with the emergence of novel toxicities, adding to up to those observed in the tyrosine-kinase inhibitor (TKI) era. Indeed, the introduction of immune checkpoint inhibitors (ICIs) alone or in combination has been associated with the development of immune-related adverse events (irAEs) involving multiple-organ systems which, even if rarely, had led to fatal outcomes. Moreover, due to the relatively recent addition of ICIs to the previously available treatments, the potential additive adverse effects of these combinations are still unknown. A prompt recognition and management of these toxicities currently represents a fundamental issue in oncology, since it correlates with the outcome of cancer patients. Even if clinical guidelines provide indications for the management of irAEs, no specific protocol to evaluate the individual risk of developing an adverse event during therapy is currently available. A multidisciplinary approach addressing appropriate interventions aimed at reducing the risk of any insidious, severe, and/or dose-limiting toxicity might represent the most efficacious strategy to timely prevent and manage severe irAEs, allowing indirectly to improve both patients’ cancer-specific survival and quality of life. In this review, we reported a five-case series of toxicity events that occurred at our center during treatment for mRCC followed by the remarks of physicians from different specialties, pinpointing the relevant role of an integrated and extended multidisciplinary team in a modern model of mRCC patient management.

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Multidisciplinary management of metastatic renal cell carcinoma in the era of targeted therapies

Cited by 10 publications

References 30 publications

Current Practices in the Management of Adverse Events Associated With Targeted Therapies for Advanced Renal Cell Carcinoma: A National Survey of Oncologists

Current Practices in the Management of Adverse Events Associated With Targeted Therapies for Advanced Renal Cell Carcinoma: A National Survey of Oncologists

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The value of the multidisciplinary team in metastatic renal cell carcinoma: Paving the way for precision medicine in toxicities management

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